Provider Demographics
NPI:1114931763
Name:SAGHARI, SOGOL (MD)
Entity Type:Individual
Prefix:DR
First Name:SOGOL
Middle Name:
Last Name:SAGHARI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9201 W SUNSET BLVD STE 602
Mailing Address - Street 2:BOX 016960 (M851)
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90069-3707
Mailing Address - Country:US
Mailing Address - Phone:310-246-0495
Mailing Address - Fax:310-246-0496
Practice Address - Street 1:113 WATERWORKS WAY STE 235
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3175
Practice Address - Country:US
Practice Address - Phone:949-679-6564
Practice Address - Fax:949-679-6554
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME96265207N00000X
CA95790207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology